Provider Demographics
NPI:1821855065
Name:AYESHA, ALIZEY
Entity Type:Individual
Prefix:
First Name:ALIZEY
Middle Name:
Last Name:AYESHA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8455 BRETON WAY
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28075-3607
Mailing Address - Country:US
Mailing Address - Phone:765-602-5546
Mailing Address - Fax:
Practice Address - Street 1:226 AIRPORT RD STE 30
Practice Address - Street 2:
Practice Address - City:ARDEN
Practice Address - State:NC
Practice Address - Zip Code:28704-9560
Practice Address - Country:US
Practice Address - Phone:828-579-4918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program